Ririe-Woodbury Dance Company

Parent/Guardian Name (legal name, first and last) *Student's Name (legal name, first and last) *Parent or Guardian Street Address *Parent or Guardian Phone Number *Parent or Guardian Email Address *Student's Age/Grade Level *Preferred contact method *PhoneEmail

What Fall Session does your student plan on participating in? (Please see the PARENT HANDBOOK on the website for a complete list of dates, times, and location addresses)

Fall Session @ Rose Wagner Performing Arts Center - 2 DAYS A WEEK (21 classes)Fall Session @ Rose Wagner Performing Arts Center - 1 DAY A WEEK (12 classes)

If you are enrolling your student for one day a week at our Rose Wagner location, which day will your student be attending?

MondaysWednesdays

Does your student have any special needs or considerations we need to be aware of?

I agree to the Student Liability Waiver (Click HERE to view) *

I agree to the terms of the Student Liability Waiver

I agree to the rules and policies set in the Parent Handbook (Click HERE to view) *

I agree to the rules and policies in the Parent Handbook

What Fall Session does your student plan on participating in? (Please see the PARENT HANDBOOK on the website for a complete list of dates, times, and location addresses)

Fall Session @ Rose Wagner Performing Arts Center - 2 DAYS A WEEK (21 classes)Fall Session @ Rose Wagner Performing Arts Center - 1 DAY A WEEK (12 classes)

If you are enrolling your student for one day a week at our Rose Wagner location, which day will your student be attending?

MondaysWednesdays

Does your student have any special needs or considerations we need to be aware of?

I agree to the Student Liability Waiver (Click HERE to view) *

I agree to the terms of the Student Liability Waiver

I agree to the rules and policies set in the Parent Handbook (Click HERE to view) *

I agree to the rules and policies in the Parent Handbook

What Fall Session does your student plan on participating in? (Please see the PARENT HANDBOOK on the website for a complete list of dates, times, and location addresses)

Fall Session @ Rose Wagner Performing Arts Center - 2 DAYS A WEEK (21 classes)Fall Session @ Rose Wagner Performing Arts Center - 1 DAY A WEEK (12 classes)

If you are enrolling your student for one day a week at our Rose Wagner location, which day will your student be attending?

MondaysWednesdays

Does your student have any special needs or considerations we need to be aware of?

I agree to the Student Liability Waiver (Click HERE to view) *

I agree to the terms of the Student Liability Waiver

I agree to the rules and policies set in the Parent Handbook (Click HERE to view) *

I agree to the rules and policies in the Parent Handbook

What Fall Session does your student plan on participating in? (Please see the PARENT HANDBOOK on the website for a complete list of dates, times, and location addresses)

Fall Session @ Rose Wagner Performing Arts Center - 2 DAYS A WEEK (21 classes)Fall Session @ Rose Wagner Performing Arts Center - 1 DAY A WEEK (12 classes)

If you are enrolling your student for one day a week at our Rose Wagner location, which day will your student be attending?

MondaysWednesdays

Does your student have any special needs or considerations we need to be aware of?

I agree to the Student Liability Waiver (Click HERE to view) *

I agree to the terms of the Student Liability Waiver

I agree to the rules and policies set in the Parent Handbook (Click HERE to view) *

I agree to the rules and policies in the Parent Handbook

Parent/Guardian Name (legal name, first and last) *

Student's Name (legal name, first and last) *

Student's Age/Grade Level *

Student's School Name *

Phone number

email address *

Would you like to receive text reminders and information closer to the event date?YesNo

Liability Release Form: In consideration of the acceptance of my application for the Ririe-Woodbury Dance Company’s Winter Workshop I hereby waive, release, and discharge any and all claims for damages for personal injury, property damages or which may hereafter occur to me as a result of participation in said event. I understand that participation in the dance activities involve certain inherent risks. Such risks are typically that of broken bones or contusions, but may also include severe injury or death.In order to obtain the desired benefit of participation in, use and enjoyment of the program’s activities, I fully release Ririe-Woodbury Dance Company, its respective employees, representatives and agents, from any and all liability for injury or damage to me resulting from my participation in the program, including, but not limited to, a complete and full release of liability for injuries resulting from the carelessness or negligence of the Ririe-Woodbury Dance Company, its respective employees, representatives and agents.I further agree to fully and completely indemnify the Ririe-Woodbury Dance Company, its respective employees, representatives, and agents, from any and all damages, whatsoever, which may result from my participation in the workshop.YesNo

2024 MEDIA CONSENT. The undersigned hereby grants permission to Ririe-Woodbury Dance Company and its successors and assigns, to publish or cause the publication of my child(ren)'s Photograph, Videotaped Image, and Quotes/Comments for promotional and educational purposes in any and all media without limitation, reservation or compensation.YesNo

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